1
|
Küpper JC, Zandiyeh P, Ronsky JL. Empirical joint contact mechanics: A comprehensive review. Proc Inst Mech Eng H 2023; 237:147-162. [PMID: 36468563 DOI: 10.1177/09544119221137397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Empirical joint contact mechanics measurement (EJCM; e.g. contact area or force, surface velocities) enables critical investigations of the relationship between changing joint mechanics and the impact on surface-to-surface interactions. In orthopedic biomechanics, understanding the changes to cartilage contact mechanics following joint pathology or aging is critical due to its suggested role in the increased risk of osteoarthritis (OA), which might be due to changed kinematics and kinetics that alter the contact patterns within a joint. This article reviews and discusses EJCM approaches that have been applied to articulating joints such that readers across different disciplines will be informed of the various measurement and analysis techniques used in this field. The approaches reviewed include classical measurement approaches (radiographic and sectioning, dye staining, casting, surface proximity, and pressure measurement), stereophotogrammetry/motion analysis, computed tomography (CT), magnetic resonance imaging (MRI), and high-speed videoradiography. Perspectives on approaches to advance this field of EJCM are provided, including the value of considering relative velocity in joints, tractional stress, quantification of joint contact area shape, consideration of normalization techniques, net response (superposition) of multiple input variables, and establishing linkages to regional cartilage health status. EJCM measures continue to provide insights to advance our understanding of cartilage health and degeneration and provide avenues to assess the efficacy and guide future directions of developing interventions (e.g. surgical, biological, rehabilitative) to optimize joint's health and function long term.
Collapse
Affiliation(s)
- Jessica C Küpper
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB, Canada.,McCaig Institute for Bone and Joint Health, Calgary, AB, Canada
| | - Payam Zandiyeh
- Department of Orthopaedic Surgery, University of Texas Health Sciences Center, Houston, TX, USA
| | - Janet L Ronsky
- McCaig Institute for Bone and Joint Health, Calgary, AB, Canada.,Departments of Mechanical and Manufacturing Engineering and Biomedical Engineering, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
2
|
Ayobami OO, Goldring SR, Goldring MB, Wright TM, van der Meulen MCH. Contribution of joint tissue properties to load-induced osteoarthritis. Bone Rep 2022; 17:101602. [PMID: 35899096 PMCID: PMC9309407 DOI: 10.1016/j.bonr.2022.101602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/29/2022] [Accepted: 07/11/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Clinical evidence suggests that abnormal mechanical forces play a major role in the initiation and progression of osteoarthritis (OA). However, few studies have examined the mechanical environment that leads to disease. Thus, using a mouse tibial loading model, we quantified the cartilage contact stresses and examined the effects of altering tissue material properties on joint stresses during loading. Design Using a discrete element model (DEA) in conjunction with joint kinematics data from a murine knee joint compression model, the magnitude and distribution of contact stresses in the tibial cartilage during joint loading were quantified at levels ranging from 0 to 9 N in 1 N increments. In addition, a simplified finite element (FEA) contact model was developed to simulate the knee joint, and parametric analyses were conducted to investigate the effects of altering bone and cartilage material properties on joint stresses during compressive loading. Results As loading increased, the peak contact pressures were sufficient to induce fibrillations on the cartilage surfaces. The computed areas of peak contact pressures correlated with experimentally defined areas of highest cartilage damage. Only alterations in cartilage properties and geometry caused large changes in cartilage contact pressures. However, changes in both bone and cartilage material properties resulted in significant changes in stresses induced in the bone during compressive loading. Conclusions The level of mechanical stress induced by compressive tibial loading directly correlated with areas of biological change observed in the mouse knee joint. These results, taken together with the parametric analyses, are the first to demonstrate both experimentally and computationally that the tibial loading model is a useful preclinical platform with which to predict and study the effects of modulating bone and/or cartilage properties on attenuating OA progression. Given the direct correlation between computational modeling and experimental results, the effects of tissue-modifying treatments may be predicted prior to in vivo experimentation, allowing for novel therapeutics to be developed.
Collapse
Affiliation(s)
- Olufunmilayo O Ayobami
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States of America
| | - Steven R Goldring
- Research Division, Hospital for Special Surgery, New York, NY, United States of America
| | - Mary B Goldring
- Research Division, Hospital for Special Surgery, New York, NY, United States of America
| | - Timothy M Wright
- Research Division, Hospital for Special Surgery, New York, NY, United States of America
| | - Marjolein C H van der Meulen
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States of America.,Research Division, Hospital for Special Surgery, New York, NY, United States of America
| |
Collapse
|
3
|
Rabe KG, Stockman TJ, Kern AM, Wirth W, Eckstein F, Sharma L, Lynch JA, Nevitt MC, Anderson DD, Segal NA. Longitudinal Relationship Between Tibiofemoral Contact Stress at Baseline and Worsening of Knee Pain Over 84 Months in the Multicenter Osteoarthritis Study. Am J Phys Med Rehabil 2022; 101:726-732. [PMID: 34620738 PMCID: PMC8986881 DOI: 10.1097/phm.0000000000001899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to determine whether tibiofemoral contact stress predicts risk for worsening knee pain over 84 ms in adults aged 50-79 yrs with or at elevated risk for knee osteoarthritis. DESIGN Baseline tibiofemoral contact stress was estimated using discrete element analysis. Other baseline measures included weight, height, hip-knee-ankle alignment, Kellgren-Lawrence grade, and Western Ontario and McMaster Universities Osteoarthritis Index pain subscale. Logistic regression models assessed the association between baseline contact stress and 84-mo worsening of Western Ontario and McMaster Universities Osteoarthritis Index pain subscale. RESULTS Data from the dominant knee (72.6% Kellgren-Lawrence grade 0/1 and 27.4% Kellgren-Lawrence grade ≥ 2) of 208 participants (64.4% female, mean ± SD body mass index = 29.6 ± 5.1 kg/m 2 ) were analyzed. Baseline mean and peak contact stress were 3.3 ± 0.9 and 9.4 ± 4.3 MPa, respectively. Forty-seven knees met the criterion for worsening pain. The highest tertiles in comparison with the lowest tertiles of mean (odds ratio [95% confidence interval] = 2.47 [1.03-5.95], P = 0.04) and peak (2.49 [1.03-5.98], P = 0.04) contact stress were associated with worsening pain at 84 mos, after adjustment for age, sex, race, clinic site, and baseline pain. Post hoc sensitivity analyses including adjustment for body mass index and hip-knee-ankle alignment attenuated the effect. CONCLUSIONS These findings suggest that elevated tibiofemoral contact stress can predict the development of worsening of knee pain.
Collapse
Affiliation(s)
- Kaitlin G Rabe
- From the University of Kansas Medical Center, Kansas City, Kansas (KGR, NAS); University of Iowa, Iowa City, Iowa (TJS, AMK, DDA, NAS); Department of Imaging and Funktional Musculoskeletal Research, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria (WW, FE); Chondrometrics GmbH, Ainring, Germany (WW, FE); Northwestern University, Chicago, Illinois (LS); and University of California San Francisco, San Francisco, California (JAL, MCN)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Automated 3D Analysis of Clinical Magnetic Resonance Images Demonstrates Significant Reductions in Cam Morphology Following Arthroscopic Intervention in Contrast to Physiotherapy. Arthrosc Sports Med Rehabil 2022; 4:e1353-e1362. [PMID: 36033193 PMCID: PMC9402425 DOI: 10.1016/j.asmr.2022.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To obtain automated measurements of cam volume, surface area, and height from baseline (preintervention) and 12-month magnetic resonance (MR) images acquired from male and female patients allocated to physiotherapy (PT) or arthroscopic surgery (AS) management for femoroacetabular impingement (FAI) in the Australian FASHIoN trial. Methods An automated segmentation pipeline (CamMorph) was used to obtain cam morphology data from three-dimensional (3D) MR hip examinations in FAI patients classified with mild, moderate, or major cam volumes. Pairwise comparisons between baseline and 12-month cam volume, surface area, and height data were performed within the PT and AS patient groups using paired t-tests or Wilcoxon signed-rank tests. Results A total of 43 patients were included with 15 PT patients (9 males, 6 females) and 28 AS patients (18 males, 10 females) for premanagement and postmanagement cam morphology assessments. Within the PT male and female patient groups, there were no significant differences between baseline and 12-month mean cam volume (male: 1269 vs 1288 mm3, t[16] = −0.39; female: 545 vs 550 mm,3t[10] = −0.78), surface area (male: 1525 vs 1491 mm2, t[16] = 0.92; female: 885 vs 925 mm,2t[10] = −0.78), maximum height (male: 4.36 vs 4.32 mm, t[16] = 0.34; female: 3.05 vs 2.96 mm, t[10] = 1.05) and average height (male: 2.18 vs 2.18 mm, t[16] = 0.22; female: 1.4 vs 1.43 mm, t[10] = −0.38). In contrast, within the AS male and female patient groups, there were significant differences between baseline and 12-month cam volume (male: 1343 vs 718 mm3, W = 0.0; female: 499 vs 240 mm3, t[18] = 2.89), surface area (male: 1520 vs 1031 mm2, t(34) = 6.48; female: 782 vs 483 mm2, t(18) = 3.02), maximum-height (male: 4.3 vs 3.42 mm, W = 13.5; female: 2.85 vs 2.24 mm, t(18) = 3.04) and average height (male: 2.17 vs 1.52 mm, W = 3.0; female: 1.4 vs 0.94 mm, W = 3.0). In AS patients, 3D bone models provided good visualization of cam bone mass removal postostectomy. Conclusions Automated measurement of cam morphology from baseline (preintervention) and 12-month MR images demonstrated that the cam volume, surface area, maximum-height, and average height were significantly smaller in AS patients following ostectomy, whereas there were no significant differences in these cam measures in PT patients from the Australian FASHIoN study. Level of Evidence Level II, cohort study.
Collapse
|
5
|
Ramaraju H, Sferra SR, Kunisaki SM, Hollister SJ. Finite element analysis of esophageal atresia repair with biodegradable polymer sleeves. J Mech Behav Biomed Mater 2022; 133:105349. [DOI: 10.1016/j.jmbbm.2022.105349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
|
6
|
Burson-Thomas CB, Dickinson AS, Browne M. Quantifying Joint Congruence with an Elastic Foundation. J Biomech Eng 2022; 144:1140056. [PMID: 35388396 DOI: 10.1115/1.4054276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Indexed: 11/08/2022]
Abstract
The level of congruence between the articulating surfaces of a diarthrodial joint can vary substantially between individuals. Quantifying joint congruence using the most widespread metric, the 'congruence index', is not straightforward: the areas of the segmented bone that constitute the articular surfaces require accurate identification, their shape must be carefully described with appropriate functions, and the relative orientation of the surfaces measured precisely. In this work, we propose a new method of measuring joint congruence, which does not require these steps. First, a Finite Element (FE) simulation of an elastic layer compressed between each set of segmented bones is performed. These are then interpreted using the elastic foundation model, enabling an equivalent, but simpler, contact geometry to be identified. From this, the equivalent radius (quantification of joint congruence) is found. This defines the radius of a sphere contacting plane (or 'ball on flat') that produces an equivalent contact to that in each joint. The minimal joint space width (in this joint position) can also be estimated from the FE simulations. The new method has been applied to 10 healthy instances of the thumb metacarpophalangeal (MCP) joint. The ten thumb MCPs had similar levels and variability of congruence as the other diarthrodial joints that have been characterised previously. This new methodology enables efficient quantification of joint congruence and minimal joint space width directly from CT or MRI derived bone geometry in any relative orientation. It lends itself to large data sets and coupling with kinematic models.
Collapse
Affiliation(s)
- Charles B Burson-Thomas
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, University of Southampton, UK
| | - Alexander S Dickinson
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, University of Southampton, UK
| | - Martin Browne
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, University of Southampton, UK
| |
Collapse
|
7
|
Zhang H, Wu Y, Li W, Chen H. Clinical significance and mechanism of LncRNA GAS-5 in osteoarthritis. Am J Transl Res 2021; 13:8465-8470. [PMID: 34377344 PMCID: PMC8340142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the clinical significance and mechanism of LncRNA GAS-5 in osteoarthritis. METHODS 67 patients with knee osteoarthritis (the case group) and 60 patients who underwent physical examination (the healthy group) were selected to evaluate the expression level of lncRNA GAS-5 in peripheral blood mononuclear cells. Cell experiments were conducted that took THP-1 cells carrying NC-shRNA (negative lentivirus) as the control group, and THP1 cells carrying GAS5-shRNA (lentivirus infection) as the study group; we evaluated the expression of lncRNA GAS-5 gene, and the expression of immune-related cytokines. RESULTS (1) The expression of lncRNA GAS-5 in the case group was lower than in the healthy group (P<0.05). (2) The expression level of lncRNA GAS-5 in the case group versus control group, had an inhibition rate of 65.49% (P<0.05). The expression levels of 18 cytokines such as IL-1, IL-2, IL-6, IL-7, IL-17, G-CSF, M-CSF, and TGF-β1, in the study group were higher than in the control group (P<0.05), but the expression of IL-10 and IL-13 were significantly lower than in the control group (P<0.05). CONCLUSION The expression of lncRNA GAS-5 is low in osteoarthritis patients. While the expression of lncRNA GAS-5 is inhibited, related immune and inflammatory factors are also affected, so lncRNA GAS-5 may affect the occurrence and progression of osteoarthritis through immune regulation. A low level of lncRNA GAS-5 may be a marker for the occurrence and progression of osteoarthritis.
Collapse
Affiliation(s)
- Haijie Zhang
- Orthopaedic Department of Guangrao County People’s HospitalDongying, China
| | - Yang Wu
- Department of Orthopaedics, Dongchangfu District Hospital of Traditional Chinese MedicineLiaocheng, China
| | - Wenxia Li
- Liaocheng Third People’s Hospital Nursing DepartmentLiaocheng, China
| | - Haihu Chen
- Department of Orthopaedics, Shengli HospitalDongying City, Shandong Province, China
| |
Collapse
|
8
|
Van Houcke J, Khanduja V, Audenaert EA. Accurate Arthroscopic Cam Resection Normalizes Contact Stresses in Patients With Femoroacetabular Impingement. Am J Sports Med 2021; 49:42-48. [PMID: 33237821 DOI: 10.1177/0363546520974378] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Femoroacetabular impingement (FAI) is increasingly recognized as a cause of hip pain in young adults. The condition leads to chondrolabral separation and chondral delamination and eventually predisposes to osteoarthritis of the hip. FAI that inflicts cartilage damage has been observed in hips with abnormal morphological characteristics and is related to a long-term evolution toward osteoarthritis. Arthroscopic surgery, which allows for correction of morphological characteristics and restores impingement-free motions, is the current standard of treatment. HYPOTHESIS Arthroscopic cam resection can restore the normal mechanical environment of the hip joint in cam-type FAI. STUDY DESIGN Descriptive laboratory study. METHODS Patient-specific discrete element models from 10 patients with cam-type FAI (all male; age, 18-40 years) were defined based on preoperative computed tomography scans and postoperative magnetic resonance imaging (MRI) scans. Complete cam resection postoperatively on MRI was confirmed with alpha angles <55°. The preoperative and postoperative peak contact stress findings during impingement testing were compared against a matched control group. RESULTS Peak contact stress was significantly elevated in patients with cam-type FAI during impingement testing, with increasing amounts of internal hip rotation (26.6 ± 11.64 MPa in cam patients preoperatively, 12.1 ± 4.62 MPa in those same patients postoperatively, and 11.4 ± 1.72 MPa in the virtual control group during impingement testing at 20° of internal hip rotation; P < .01). This effect was normalized after arthroscopic cam resection and loading patterns matched those of the control group. CONCLUSION Accurate arthroscopic cam resection restored the normal peak joint contact stresses in the hip joint. This highlights the importance of early and complete cam resections in the face of a positive diagnosis of cam-type FAI. CLINICAL RELEVANCE Treatment of cam-type FAI effectively normalizes hip joint contact mechanics.
Collapse
Affiliation(s)
- Jan Van Houcke
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Electromechanics, Op3Mech research group, University of Antwerp, Antwerp, Belgium
| | - Vikas Khanduja
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Young Adult Hip Service, Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emmanuel A Audenaert
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Electromechanics, Op3Mech research group, University of Antwerp, Antwerp, Belgium.,Young Adult Hip Service, Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
9
|
Li M, Venäläinen MS, Chandra SS, Patel R, Fripp J, Engstrom C, Korhonen RK, Töyräs J, Crozier S. Discrete element and finite element methods provide similar estimations for hip joint contact mechanics during walking gait. J Biomech 2020; 115:110163. [PMID: 33338974 DOI: 10.1016/j.jbiomech.2020.110163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/07/2020] [Accepted: 11/25/2020] [Indexed: 12/13/2022]
Abstract
Finite element analysis (FEA) provides a powerful approach for estimating the in-vivo loading characteristics of the hip joint during various locomotory and functional activities. However, time-consuming procedures, such as the generation of high-quality FE meshes and setup of FE simulation, typically make the method impractical for rapid applications which could be used in clinical routine. Alternatively, discrete element analysis (DEA) has been developed to quantify mechanical conditions of the hip joint in a fraction of time compared to FEA. Although DEA has proven effective in the estimation of contact stresses and areas in various complex applications, it has not yet been well characterised by its ability to evaluate contact mechanics for the hip joint during gait cycle loading using data from several individuals. The objective of this work was to compare DEA modelling against well-established FEA for analysing contact mechanics of the hip joint during walking gait. Subject-specific models were generated from magnetic resonance images of the hip joints in five asymptomatic subjects. The DEA and FEA models were then simulated for 13 loading time-points extracted from a full gait cycle. Computationally, DEA was substantially more efficient compared to FEA (simulation times of seconds vs. hours). The DEA and FEA methods had similar predictions for contact pressure distribution for the hip joint during normal walking. In all 13 simulated loading time-points across five subjects, the maximum difference in average contact pressures between DEA and FEA was within ±0.06 MPa. Furthermore, the difference in contact area ratio computed using DEA and FEA was less than ±6%.
Collapse
Affiliation(s)
- Mao Li
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Mikko S Venäläinen
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia; Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.
| | - Shekhar S Chandra
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Rushabh Patel
- School of Mechanical and Mining Engineering, University of Queensland, Brisbane, Australia
| | - Jurgen Fripp
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia; The Australian e-Health Research Centre, CSIRO Health and Biosecurity, Brisbane, Australia
| | - Craig Engstrom
- School of Human Movement Studies, University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland
| | - Stuart Crozier
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| |
Collapse
|
10
|
Mohammadi A, Myller KAH, Tanska P, Hirvasniemi J, Saarakkala S, Töyräs J, Korhonen RK, Mononen ME. Rapid CT-based Estimation of Articular Cartilage Biomechanics in the Knee Joint Without Cartilage Segmentation. Ann Biomed Eng 2020; 48:2965-2975. [PMID: 33179182 PMCID: PMC7723937 DOI: 10.1007/s10439-020-02666-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/17/2020] [Indexed: 12/30/2022]
Abstract
Knee osteoarthritis (OA) is a painful joint disease, causing disabilities in daily activities. However, there is no known cure for OA, and the best treatment strategy might be prevention. Finite element (FE) modeling has demonstrated potential for evaluating personalized risks for the progression of OA. Current FE modeling approaches use primarily magnetic resonance imaging (MRI) to construct personalized knee joint models. However, MRI is expensive and has lower resolution than computed tomography (CT). In this study, we extend a previously presented atlas-based FE modeling framework for automatic model generation and simulation of knee joint tissue responses using contrast agent-free CT. In this method, based on certain anatomical dimensions measured from bone surfaces, an optimal template is selected and scaled to generate a personalized FE model. We compared the simulated tissue responses of the CT-based models with those of the MRI-based models. We show that the CT-based models are capable of producing similar tensile stresses, fibril strains, and fluid pressures of knee joint cartilage compared to those of the MRI-based models. This study provides a new methodology for the analysis of knee joint and cartilage mechanics based on measurement of bone dimensions from native CT scans.
Collapse
Affiliation(s)
- Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.
| | - Katariina A H Myller
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,Department of Medical Physics, Turku University Central Hospital, 20500, Turku, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Jukka Hirvasniemi
- Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| |
Collapse
|
11
|
Moldovan F, Gligor A, Bataga T. Integration of Three-dimensional Technologies in Orthopedics: A Tool for Preoperative Planning of Tibial Plateau Fractures. Acta Inform Med 2020; 28:278-282. [PMID: 33627930 PMCID: PMC7879455 DOI: 10.5455/aim.2020.28.278-282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: There is a growing scientific interest in the use of three-dimensional (3D) technologies in orthopedic surgery. Digitalization makes research in orthopedics more accurate and quantitative. Scientific literature describes an overview of current 3D technologies applications in orthopedics, without any emphasis on integrating available technologies as a clinical workflow. Objective: To develop a clinical workflow integrating 3D technologies for patient-specific applications in orthopedics validated in practice by employment of a free 3D software solution with the aim of minimizing the intervention. Method: By exploring the applications of 3D technologies in orthopedic surgery, we have created a clinical workflow integrating 3D technologies for patient-specific applications in orthopedics. It is validated in practice for preoperative planning of a 49-year-old male patient who had a tibial plateau fracture of Schatzker type VI in his right leg. The software solution we have used is Democratiz3D, from Embodi3d platform, which allows patient-specific modeling and surgical planning. Results: By using the proposed methodology we obtained the model of the tibial plateau fracture Schatzker type VI, as a “solid” representation in stl type files, which represents a numerically defined geometry of the bones fragments. It helps surgeons in planning the surgical approach. The time from the beginning to the end of the analysis was 193 min, which is 15% lower than times reported in similar studies. Conclusion: The planning potential of the 3D solution is a valuable instrument for surgeons in exploring the nature of tibial plateau fractures and the formulation of a suitable surgical plan for surface alignment, design and screw fixation guides, strength calculations of bone fragments, and printing surgical objects.
Collapse
Affiliation(s)
- Flaviu Moldovan
- IOSUD Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Adrian Gligor
- Biomedical Research Center, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Tiberiu Bataga
- Department of Orthopedics-Traumatology, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| |
Collapse
|
12
|
Cam FAI and Smaller Neck Angles Increase Subchondral Bone Stresses During Squatting: A Finite Element Analysis. Clin Orthop Relat Res 2019; 477:1053-1063. [PMID: 30516652 PMCID: PMC6494292 DOI: 10.1097/corr.0000000000000528] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Individuals with a cam deformity and a decreased (varus) femoral neck-shaft angle may be predisposed to symptomatic femoroacetabular impingement (FAI). However, it is unclear what combined effects the cam deformity and neck angle have on acetabular cartilage and subchondral bone stresses during an impinging squat motion. We therefore used finite element analysis to examine the combined effects of cam morphology and femoral neck-shaft angle on acetabular cartilage and subchondral bone stresses during squatting, examining the differences in stress characteristics between symptomatic and asymptomatic individuals with cam deformities and individuals without cam deformities and no hip pain. QUESTIONS/PURPOSES Using finite element analysis in this population, we asked: (1) What are the differences in acetabular cartilage stresses? (2) What are the differences in subchondral bone stresses? (3) What are the effects of high and low femoral neck-shaft angles on these stresses? METHODS Six male participants were included to represent three groups (symptomatic cam, asymptomatic cam, control without cam deformity) with two participants per group, one with the highest femoral neck-shaft angle and one with the lowest (that is, most valgus and most varus neck angles, respectively). Each participant's finite element hip models were reconstructed from imaging data and assigned subject-specific bone material properties. Hip contact forces during squatting were determined and applied to the finite element models to examine maximum shear stresses in the acetabular cartilage and subchondral bone. RESULTS Both groups with cam deformities experienced higher subchondral bone stresses than cartilage stresses. Both groups with cam deformities also had higher subchondral bone stresses (symptomatic with high and low femoral neck-shaft angle = 14.1 and 15.8 MPa, respectively; asymptomatic with high and low femoral neck-shaft angle = 10.9 and 13.0 MPa, respectively) compared with the control subjects (high and low femoral neck-shaft angle = 6.4 and 6.5 MPa, respectively). The symptomatic and asymptomatic participants with low femoral neck-shaft angles had the highest cartilage and subchondral bone stresses in their respective subgroups. The asymptomatic participant with low femoral neck-shaft angle (123°) demonstrated anterolateral subchondral bone stresses (13.0 MPa), similar to the symptomatic group. The control group also showed no differences between cartilage and subchondral bone stresses. CONCLUSIONS The resultant subchondral bone stresses modeled here coincide with findings that acetabular subchondral bone is denser in hips with cam lesions. Future laboratory studies will expand the parametric finite element analyses, varying these anatomic and subchondral bone stiffness parameters to better understand the contributions to the pathomechanism of FAI. CLINICAL RELEVANCE Individuals with a cam deformity and more varus neck orientation may experience elevated subchondral bone stresses, which may increase the risks of early clinical signs and degenerative processes associated with FAI, whereas individuals with cam morphology and normal-to-higher femoral neck-shaft angles may be at lesser risk of disease progression that would potentially require surgical intervention.
Collapse
|
13
|
Theoretical Evaluation and Experimental Validation of Localized Therapeutic Hypothermia Application to Preserve Residual Hearing After Cochlear Implantation. Ear Hear 2019; 39:712-719. [PMID: 29240567 DOI: 10.1097/aud.0000000000000529] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implantation surgery has been shown to result in trauma to inner ear sensory structures, resulting in loss of residual hearing. Localized therapeutic hypothermia has been shown in clinical care to be a neuroprotective intervention. Previously, we have shown in an experimental model that localized hypothermia protects cochlear hair cells and residual hearing function against surgical and cochlear implantation trauma. Using experimental temperature measurements carried out in human cadaver temporal bones and a finite element model of the inner ear, the present study examined the temperature distribution of a custom-designed hypothermia delivery system in the human inner ear organs. DESIGN The efficacy of the hypothermia probe and resulting heat distribution across human cochlea and surrounding tissues were modeled in three-dimensional in COMSOL. The geometry and dimensions of inner ear and temporal bones were derived from computed tomographic and magnetic resonance imaging images. Model predictions were compared with experimental observations from five human temporal bones. RESULTS In both the modeling and experimental studies, the cochlear temperature was lowered by 4 to 6 °C on the round window from a baseline of 37 °C within 16 to 18 minutes. The model simulations showed uniformly distributed cooling across the cochlea. This study provides insight for design, operation, and protocols for efficacious delivery of mild therapeutic hypothermia to the human cochlea that may significantly benefit patients undergoing surgical cochlear implantation by preserving residual hearing. CONCLUSION There was a close correlation between the results of the numerical simulations and experimental observations in this study. Our custom-designed system is capable of effectively providing mild therapeutic hypothermia locally to the human cochlea. When combined with results from in vivo animal experiments, the present study suggests that the application of localized therapeutic hypothermia may hold potential for patients with an aim to preserve residual hearing after cochlear implantation.
Collapse
|
14
|
Maas SA, LaBelle SA, Ateshian GA, Weiss JA. A Plugin Framework for Extending the Simulation Capabilities of FEBio. Biophys J 2018; 115:1630-1637. [PMID: 30297132 DOI: 10.1016/j.bpj.2018.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/05/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022] Open
Abstract
The FEBio software suite is a set of software tools for nonlinear finite element analysis in biomechanics and biophysics. FEBio employs mixture theory to account for the multiconstituent nature of biological materials, integrating the field equations for irreversible thermodynamics, solid mechanics, fluid mechanics, mass transport with reactive species, and electrokinetics. This communication describes the development and application of a new "plugin" framework for FEBio. Plugins are dynamically linked libraries that allow users to add new features and to couple FEBio with other domain-specific software applications without modifying the source code directly. The governing equations and simulation capabilities of FEBio are reviewed. The implementation, structure, use, and application of the plugin framework are detailed. Several example plugins are described in detail to illustrate how plugins enrich, extend, and leverage existing capabilities in FEBio, including applications to deformable image registration, constitutive modeling of biological tissues, coupling to an external software package that simulates angiogenesis using a discrete computational model, and a nonlinear reaction-diffusion solver. The plugin feature facilitates dissemination of new simulation methods, reproduction of published results, and coupling of FEBio with other domain-specific simulation approaches such as compartmental modeling, agent-based modeling, and rigid-body dynamics. We anticipate that the new plugin framework will greatly expand the range of applications for the FEBio software suite and thus its impact.
Collapse
Affiliation(s)
- Steve A Maas
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - Steven A LaBelle
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - Gerard A Ateshian
- Department of Mechanical Engineering, Columbia University, New York, New York
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah.
| |
Collapse
|
15
|
Hip chondrolabral mechanics during activities of daily living: Role of the labrum and interstitial fluid pressurization. J Biomech 2018; 69:113-120. [PMID: 29366559 DOI: 10.1016/j.jbiomech.2018.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/29/2017] [Accepted: 01/08/2018] [Indexed: 11/21/2022]
Abstract
Osteoarthritis of the hip can result from mechanical factors, which can be studied using finite element (FE) analysis. FE studies of the hip often assume there is no significant loss of fluid pressurization in the articular cartilage during simulated activities and approximate the material as incompressible and elastic. This study examined the conditions under which interstitial fluid load support remains sustained during physiological motions, as well as the role of the labrum in maintaining fluid load support and the effect of its presence on the solid phase of the surrounding cartilage. We found that dynamic motions of gait and squatting maintained consistent fluid load support between cycles, while static single-leg stance experienced slight fluid depressurization with significant reduction of solid phase stress and strain. Presence of the labrum did not significantly influence fluid load support within the articular cartilage, but prevented deformation at the cartilage edge, leading to lower stress and strain conditions in the cartilage. A morphologically accurate representation of collagen fibril orientation through the thickness of the articular cartilage was not necessary to predict fluid load support. However, comparison with simplified fibril reinforcement underscored the physiological importance. The results of this study demonstrate that an elastic incompressible material approximation is reasonable for modeling a limited number of cyclic motions of gait and squatting without significant loss of accuracy, but is not appropriate for static motions or numerous repeated motions. Additionally, effects seen from removal of the labrum motivate evaluation of labral reattachment strategies in the context of labral repair.
Collapse
|
16
|
Ulna-humerus contact mechanics: Finite element analysis and experimental measurements using a tactile pressure sensor. Med Eng Phys 2017; 50:22-28. [PMID: 28890302 DOI: 10.1016/j.medengphy.2017.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/09/2017] [Accepted: 08/21/2017] [Indexed: 11/23/2022]
Abstract
Elbow articular cartilage withstands high compressive and shear forces while protecting the bone from excessive loading. Better understanding of elbow cartilage contact mechanics can provide insight into cartilage degeneration. In this study a tactile pressure sensor was used to measure the contact pressure distribution within the ulno-humeral joint of two cadaver specimens at 20° flexion angle across three different axial loads of 80 N, 110 N, and 140 N. Corresponding 3D finite element (FE) models were constructed from magnetic resonance imaging (MRI) and contact analysis was performed for each specimen with boundary and loading conditions identical to the experiment. Direct comparison between FE results and experimental measurements was conducted for the validation of the FE models and a sensitivity analysis was employed for assessing the effect of cartilage parameters on the model's outputs. The results showed a good agreement between the FE models and the experiments in terms of contact characteristics. The sensitivity analysis demonstrated that outcomes of the model, particularly peak contact pressure is more sensitive to the Poisson's ratio rather than to Young's modulus under static conditions. This result suggests that selection of Poisson's ratio is very critical for accurate prediction of contact mechanics within the ulno-humeral joint.
Collapse
|
17
|
Kapitanov GI, Ayati BP, Martin JA. Modeling the effect of blunt impact on mitochondrial function in cartilage: implications for development of osteoarthritis. PeerJ 2017; 5:e3468. [PMID: 28729949 PMCID: PMC5516774 DOI: 10.7717/peerj.3468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 05/26/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Osteoarthritis (OA) is a disease characterized by degeneration of joint cartilage. It is associated with pain and disability and is the result of either age and activity related joint wear or an injury. Non-invasive treatment options are scarce and prevention and early intervention methods are practically non-existent. The modeling effort presented in this article is constructed based on an emerging biological hypothesis-post-impact oxidative stress leads to cartilage cell apoptosis and hence the degeneration observed with the disease. The objective is to quantitatively describe the loss of cell viability and function in cartilage after an injurious impact and identify the key parameters and variables that contribute to this phenomenon. METHODS We constructed a system of differential equations that tracks cell viability, mitochondrial function, and concentrations of reactive oxygen species (ROS), adenosine triphosphate (ATP), and glycosaminoglycans (GAG). The system was solved using MATLAB and the equations' parameters were fit to existing data using a particle swarm algorithm. RESULTS The model fits well the available data for cell viability, ATP production, and GAG content. Local sensitivity analysis shows that the initial amount of ROS is the most important parameter. DISCUSSION The model we constructed is a viable method for producing in silico studies and with a few modifications, and data calibration and validation, may be a powerful predictive tool in the search for a non-invasive treatment for post-traumatic osteoarthritis.
Collapse
Affiliation(s)
- Georgi I Kapitanov
- Department of Mathematics, University of Iowa, Iowa City, IA, United States of America
| | - Bruce P Ayati
- Department of Mathematics, University of Iowa, Iowa City, IA, United States of America.,Program in Applied Mathematical & Computational Sciences, University of Iowa, Iowa City, IA, United States of America.,Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IA, United States of America
| | - James A Martin
- Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IA, United States of America.,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United States of America
| |
Collapse
|
18
|
Abstract
Biomechanics of the hip joint describes how the complex combination of osseous, ligamentous, and muscular structures transfers the weight of the body from the axial skeleton into the appendicular skeleton of the lower limbs. Throughout history, several biomechanical studies based on theoretical mathematics, in vitro, in vivo as well as in silico models have been successfully performed. The insights gained from these studies have improved our understanding of the development of mechanical hip pathologies such as osteoarthritis, hip fractures, and developmental dysplasia of the hip. The main treatment of end-stage degeneration of the hip is total hip arthroplasty (THA). The increasing number of patients undergoing this surgical procedure, as well as their demand for more than just pain relief and leading an active lifestyle, has challenged surgeons and implant manufacturers to deliver higher function as well as longevity with the prosthesis. The science of biomechanics has played and will continue to play a crucial and integral role in achieving these goals. The aim of this article, therefore, is to present to the readers the key concepts in biomechanics of the hip and their application to THA.
Collapse
Affiliation(s)
- Jan Van Houcke
- Department of Orthopaedics Surgery and Traumatology, Ghent University Hospital, Ghent 9000, Belgium
| | - Vikas Khanduja
- Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Christophe Pattyn
- Department of Orthopaedics Surgery and Traumatology, Ghent University Hospital, Ghent 9000, Belgium
| | - Emmanuel Audenaert
- Department of Orthopaedics Surgery and Traumatology, Ghent University Hospital, Ghent 9000, Belgium
- Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| |
Collapse
|
19
|
Abstract
The objective of this study was to examine the state of stress within the solid matrix of articular cartilage in the patellofemoral joint, using anatomically faithful biphasic models of the articular layers, with the joint subjected to physiologic muscle force magnitudes. Finite element models of five joints were created from human cadaver knees. Biphasic sliding contact analyses were performed using FEBio software to analyze the response of the joint from 30 to 60 degrees of knee flexion. Results demonstrated that the collagen matrix always sustains tensile stresses, despite the fact that the articular layers are loaded in compression. The principal direction of maximum solid stresses was consistent with the known orientation of collagen fibrils in cartilage. The magnitudes of these tensile stresses under muscle forces representative of activities of daily living were well below tensile failure stresses reported in the prior literature. Results also hinted that solid matrix stresses were higher in the patellar versus femoral superficial zone. These anatomically correct finite element models predicted outcomes consistent with our understanding of structure-function relationships in articular cartilage, while also producing solid matrix stress estimates not observable from experiments alone, yet highly relevant to our understanding of tissue degeneration.
Collapse
Affiliation(s)
- Brian K. Jones
- Graduate Research Assistant, Department of Mechanical Engineering, Columbia University, 500 West 120th Street, MC 4703, 220 S.W. Mudd, New York, NY 10027 USA
| | - Clark T. Hung
- Professor, Department of Biomedical Engineering, Columbia University, 1210 Amsterdam Avenue, MC8904, 351 Engineering Terrace, New York, NY 10027 USA
| | - Gerard A. Ateshian
- Andrew Walz Professor, Department of Mechanical Engineering, Columbia University, 500 West 120th Street, MC 4703, 220 S.W. Mudd, New York, NY 10027 USA
| |
Collapse
|
20
|
Osteoarthritis year in review 2015: mechanics. Osteoarthritis Cartilage 2016; 24:27-35. [PMID: 26707990 PMCID: PMC4693146 DOI: 10.1016/j.joca.2015.08.018] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/13/2015] [Accepted: 08/29/2015] [Indexed: 02/02/2023]
Abstract
Motivated by the conceptual framework of multi-scale biomechanics, this narrative review highlights recent major advances with a focus on gait and joint kinematics, then tissue-level mechanics, cell mechanics and mechanotransduction, matrix mechanics, and finally the nanoscale mechanics of matrix macromolecules. A literature review was conducted from January 2014 to April 2015 using PubMed to identify major developments in mechanics related to osteoarthritis (OA). Studies of knee adduction, flexion, rotation, and contact mechanics have extended our understanding of medial compartment loading. In turn, advances in measurement methodologies have shown how injuries to both the meniscus and ligaments, together, can alter joint kinematics. At the tissue scale, novel findings have emerged regarding the mechanics of the meniscus as well as cartilage superficial zone. Moving to the cell level, poroelastic and poro-viscoelastic mechanisms underlying chondrocyte deformation have been reported, along with the response to osmotic stress. Further developments have emerged on the role of calcium signaling in chondrocyte mechanobiology, including exciting findings on the function of mechanically activated cation channels newly found to be expressed in chondrocytes. Finally, AFM-based nano-rheology systems have enabled studies of thin murine tissues and brush layers of matrix molecules over a wide range of loading rates including high rates corresponding to impact injury. With OA acknowledged to be a disease of the joint as an organ, understanding mechanical behavior at each length scale helps to elucidate the connections between cell biology, matrix biochemistry and tissue structure/function that may play a role in the pathomechanics of OA.
Collapse
|
21
|
Assassi L, Magnenat-Thalmann N. Assessment of cartilage contact pressure and loading in the hip joint during split posture. Int J Comput Assist Radiol Surg 2015; 11:745-56. [PMID: 26450106 DOI: 10.1007/s11548-015-1303-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 09/15/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the crucial role of the mechanical behavior in the degenerative process of the hip joint, analyzing the contact mechanics in the articular layers during physical activities could contribute to understanding the pathology. Indeed, the development process of hip osteoarthritis generally evolves over a long time period, and therefore analyzing the mechanical behavior of the hip joint during extreme repetitive movements will be helpful to analyze degeneration causes. The aim of the study was to investigate the link between the excessive movements and the development of hip osteoarthritis. METHODS To individualize the analysis, we used a subject-specific and noninvasive approach based on finite element analysis and magnetic resonance imaging (MRI) data. The contact pressure distribution and loading conditions on the acetabular cartilage were assessed on eleven professional dancer subjects performing a split movement. This movement is frequently practiced (repetitive) by dancers during their daily exercises. Moreover, split postures are mostly characterized by high anatomical angles with subluxation (excessive). To ensure the motion accuracy, MRI data of the subjects were acquired in neutral and split positions performed inside the MRI scanner. Based on the reconstructed bone models from the MRI data, a motion tracking approach was used to compute the transformation between the two poses. To evaluate the contact during the split movement and to quantify the role of the labrum in the hip joint mechanics, additional simulations of two daily activities (walking and stand-up) were performed. Finally, a clinical study based on morphological and radiological analysis of the subjects was performed and validated by orthopedic surgeons and radiological experts to evaluate the proposed approach. RESULTS The reconstructed split movement was characterized by high anatomical angles with a subluxation on the left hip. Consequently, strong deformations and pressures were observed during the simulation. The comparison of the simulation results of split posture and daily activities showed higher pressure and lower contact area during extreme movements. Moreover, the presence of labrum absorbed part of load and consequently decreased the predicted contact pressure and contact area on the acetabular cartilage. CONCLUSION The comparison of the simulation results of the split posture and daily activities, as well as the correlation between the results of the analysis on extreme movement results and the clinical analysis performed by medical experts, strongly suggests that repetitive extreme movement could lead to early hip osteoarthritis.
Collapse
Affiliation(s)
- Lazhari Assassi
- MIRALab, CUI, University of Geneva, Battelle, Building A, 7, route de Drize, 1227, Carouge, Switzerland.
| | - Nadia Magnenat-Thalmann
- MIRALab, CUI, University of Geneva, Battelle, Building A, 7, route de Drize, 1227, Carouge, Switzerland
| |
Collapse
|
22
|
Wittek A, Grosland NM, Joldes GR, Magnotta V, Miller K. From Finite Element Meshes to Clouds of Points: A Review of Methods for Generation of Computational Biomechanics Models for Patient-Specific Applications. Ann Biomed Eng 2015; 44:3-15. [PMID: 26424475 DOI: 10.1007/s10439-015-1469-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/22/2015] [Indexed: 11/24/2022]
Abstract
It has been envisaged that advances in computing and engineering technologies could extend surgeons' ability to plan and carry out surgical interventions more accurately and with less trauma. The progress in this area depends crucially on the ability to create robustly and rapidly patient-specific biomechanical models. We focus on methods for generation of patient-specific computational grids used for solving partial differential equations governing the mechanics of the body organs. We review state-of-the-art in this area and provide suggestions for future research. To provide a complete picture of the field of patient-specific model generation, we also discuss methods for identifying and assigning patient-specific material properties of tissues and boundary conditions.
Collapse
Affiliation(s)
- Adam Wittek
- Intelligent Systems for Medicine Laboratory, The University of Western Australia, Crawley-Perth, Western Australia, Australia.
| | - Nicole M Grosland
- Department of Biomedical Engineering, The University of Iowa, Iowa City, IA, USA.,Department of Orthopaedics and Rehabilitation, The University of Iowa, Iowa City, IA, USA.,Center for Computer Aided Design, The University of Iowa, Iowa City, IA, USA
| | - Grand Roman Joldes
- Intelligent Systems for Medicine Laboratory, The University of Western Australia, Crawley-Perth, Western Australia, Australia
| | - Vincent Magnotta
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
| | - Karol Miller
- Intelligent Systems for Medicine Laboratory, The University of Western Australia, Crawley-Perth, Western Australia, Australia.,Institute of Mechanics and Advanced Materials, Cardiff School of Engineering, Cardiff University, Wales, UK
| |
Collapse
|